JCAHO cited both City of Angels and Kindred for problems in their laboratories. Surveyors noted the pathology and clinical laboratory services at City of Angels failed to meet 15 standards, including maintaining and testing equipment, creating and using reliable tests for technicians and establishing protocol for measuring negative reactions to blood transfusions.

The pathology and clinical lab services at Kindred received failing grades in 16 areas, including "complying with all applicable laws and regulation[s]," communicating effectively in the lab, providing up-to-date descriptions and instructions for methods and storing blood properly, the Times reports.

While JCAHO did not state whether patients had been harmed by the alleged errors, commission spokesperson Mark Forstneger said serious lapses in labs can lead to patient injuries and are reason enough to remove a hospital's accreditation.

Several L.A. Hospitals on JCAHO Warning List

According to Forstneger, less than 1% of inspected laboratories and hospitals nationwide receive threats about losing accreditation. He said that four of the 18 hospitals that were warned over the past two years are located in Los Angeles County.

Forstneger noted the county's hospitals appear to have a disproportionate share of problems, but he said, "It just seems like a random cluster." Forstneger added, "The same evaluation methods are used whether you're on the East Coast or West Coast."

Reaction

City of Angels spokesperson Jodi Berlin noted JCAHO's allegations only concerned lab services, adding that the facility "takes great pride in its [JCAHO] accreditation, which it has maintained since the hospital began operations, and on its ability to provide quality patient care."

Kindred Chief Operating Officer Robin Rapp said in a statement, "We take seriously any issue brought to our attention. We are actively communicating with [JCAHO] regarding their findings."

Jim Lott, a spokesperson for the Hospital Association of Southern California, said he did not know why JCAHO is discovering so many lab problems, adding that a shortage of technicians and pharmacists has "place[d] a strain on hospitals, but I don't hear that the problems are so severe that (they affect) the quality of the service coming out of the laboratory or pathology."

Lott said, "They are dotting their I's and crossing their T's, more so than before the criticism. I don't know that there's been any hue and cry in the (hospital) industry about them being bad or being too tough." He added that some hospitals have said inspectors do not always use consistent measuring standards. "A lot of hospitals have discussed or reported capricious behavior on the part of surveyors on applying the standards," he said.

JCAHO officials said that while the commission "revamped some of their inspection standards a few years ago," the agency is not being more aggressive now (Chong, Los Angeles Times, 3/24).

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